澳大利亚成人住院患者甲型和乙型流感病毒感染的临床特征和结局。
Clinical characteristics and outcomes of influenza A and B virus infection in adult Australian hospitalised patients.
机构信息
College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
Department of General Medicine, Division of Medicine, Cardiac & Critical Care, Flinders Medical Centre, Flinders Drive, Bedford Park, Adelaide, SA, 5042, Australia.
出版信息
BMC Infect Dis. 2020 Dec 1;20(1):913. doi: 10.1186/s12879-020-05670-8.
BACKGROUND
Influenza B is often perceived as a less severe strain of influenza. The epidemiology and clinical outcomes of influenza B have been less thoroughly investigated in hospitalised patients. The aims of this study were to describe clinical differences and outcomes between influenza A and B patients admitted over a period of 4 years.
METHODS
We retrospectively collected data of all laboratory confirmed influenza patients ≥18 years at two tertiary hospitals in South Australia. Patients were confirmed as influenza positive if they had a positive polymerase-chain-reaction (PCR) test of a respiratory specimen. Complications during hospitalisation along with inpatient mortality were compared between influenza A and B. In addition, 30 day mortality and readmissions were compared. Logistic regression model compared outcomes after adjustment for age, Charlson index, sex and creatinine levels.
RESULTS
Between January 2016-March 2020, 1846 patients, mean age 66.5 years, were hospitalised for influenza. Of whom, 1630 (88.3%) had influenza A and 216 (11.7%) influenza B. Influenza B patients were significantly younger than influenza A. Influenza A patients were more likely be smokers with a history of chronic obstructive pulmonary disease (COPD) and ischaemic heart disease (IHD) than influenza B. Complications, including pneumonia and acute coronary syndrome (ACS) were similar between two groups, however, septic shock was more common in patients with influenza B. Adjusted analyses showed similar median length of hospital stay (LOS), in hospital mortality, 30-day mortality and readmissions between the two groups.
CONCLUSIONS
Influenza B is less prevalent and occurs mostly in younger hospitalised patients than influenza A. Both strains contribute equally to hospitalisation burden and complications.
TRIAL REGISTRATION
Australia and New Zealand Clinical Trial Registry (ANZCR) no ACTRN12618000451202 date of registration 28/03/2018.
背景
乙型流感通常被认为是一种较温和的流感。在住院患者中，乙型流感的流行病学和临床结果尚未得到充分研究。本研究旨在描述在过去 4 年中住院的甲型和乙型流感患者之间的临床差异和结局。
方法
我们回顾性收集了南澳大利亚州两家三级医院所有≥18 岁的实验室确诊流感患者的数据。如果呼吸道标本的聚合酶链反应（PCR）检测呈阳性，则患者被确认为流感阳性。比较了甲型和乙型流感患者住院期间的并发症和住院死亡率。此外，比较了 30 天死亡率和再入院率。使用逻辑回归模型，在调整年龄、Charlson 指数、性别和肌酐水平后比较了结局。
结果
2016 年 1 月至 2020 年 3 月期间，1846 名平均年龄 66.5 岁的患者因流感住院。其中，1630 例（88.3%）为甲型流感，216 例（11.7%）为乙型流感。乙型流感患者明显比甲型流感患者年轻。与乙型流感相比，甲型流感患者更有可能是吸烟者，并有慢性阻塞性肺疾病（COPD）和缺血性心脏病（IHD）病史。两组之间的并发症，包括肺炎和急性冠状动脉综合征（ACS）相似，但乙型流感患者发生感染性休克更为常见。调整分析显示，两组的中位住院时间（LOS）、院内死亡率、30 天死亡率和再入院率相似。
结论
乙型流感比甲型流感少见，且主要发生在较年轻的住院患者中。两种流感株对住院负担和并发症的贡献相同。
试验注册
澳大利亚和新西兰临床试验注册（ANZCR），注册号 ACTRN12618000451202，注册日期 2018 年 3 月 28 日。
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